Virtual Crossmatch functionality in the CTR
Developed by Canadian Blood Services, the Canadian Transplant Registry (CTR) is the technology that will operationalize the IPOS Heart policies. The CTR is an easily accessible online website for Organ Donation Organizations, laboratories, and transplant hospitals to manage patients, donors, organ offers and transplant outcomes. The CTR will apply a standardized matching and ranking algorithm to optimize transplant success factors for those hard to match and/or medically urgent heart patients. The offer management functionality serves to enhance inter-provincial communications, accelerate medical decision making, and reduce wait times for waitlist heart recipients and grieving donor families, alike.
The CTR will also contribute uniquely Canadian data that will inform program successes, identify areas of further improvement and fuel research to improve patient transplant outcomes.
On June 4 and 5, 2019 a national consultation workshop was held to discuss current state, opportunities and challenges, and developing an implementation plan related to the IPOS Heart project. The June meeting resulted in a request to start using functionality currently available in the CTR that allows for virtual cross-match (vXM) of donor hearts with recipients on the National Organ Waitlist (NOW).
This functionality was activated in the CTR on Oct. 15, 2019 to help centers allocate hearts more efficiently using current allocation processes and algorithms. This immediate, interim function has helped reduce the allocation time of highly sensitized hearts, resulting in a more efficient process for donor coordinators and reduced wait times for donor families.
At present, the vXM functionality can only be used to produce a list of recipients that can be filtered to display those that are known to be vXM negative to the donor heart being allocated. Use of the CTR to make an offer to identified recipients is not functional at this time. This feature will be fully active for use when the full implementation is complete.
The purpose of this training packet is to explore the Virtual Cross Match function currently available in the Canadian Transplant Registry to aid the allocation of deceased donor hearts. On October 15, 2019, coordinated use of this function began across Canada, to improve the process of allocating hearts to high-status (4S) heart recipients, by providing a sorted list of those recipients that have a negative virtual cross-match to the donor.